Debentureholders Instrument Cancelation

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

Date

{{date}}

Debentureholder Details

To: {{debentureholder_name}}

{{debentureholder_address}}

Subject: Notice of Cancellation of Debenture Instrument No. {{debenture_number}}

Dear Sir/Madam,

Recitals

WHEREAS, {{company_name}} (the 'Company') issued a Debenture Instrument bearing number {{debenture_number}} (the 'Debenture') on {{issue_date}} to {{debentureholder_name}} (the 'Debentureholder') for an aggregate principal sum of {{currency}} {{principal_amount}} ({{principal_amount_words}}).

AND WHEREAS, the Company has fully satisfied all its obligations under the Debenture, including the repayment of the principal sum and all accrued interest, premiums, and other charges whatsoever due thereunder.

Cancellation of Debenture Instrument

NOW, THEREFORE, take notice that {{company_name}} hereby declares the Debenture Instrument No. {{debenture_number}} to be fully and irrevocably cancelled and extinguished with effect from {{cancellation_date}}.

The Company is hereby released and discharged from all liabilities, duties, and obligations whatsoever arising under or in connection with the said Debenture Instrument.

The Debentureholder is requested to return the original Debenture Instrument to the Company for physical cancellation and record-keeping purposes within {{days_to_return}} days from the date of this notice.

Indemnity (Optional Clause)

The Debentureholder hereby covenants and undertakes to indemnify and hold harmless the Company, its directors, officers, employees, and agents from and against any and all claims, demands, liabilities, losses, costs, and expenses (including legal fees on a full indemnity basis) which may be incurred or suffered by them arising out of or in connection with the Debenture from the date of cancellation.

Governing Law and Jurisdiction

This Notice of Cancellation shall be governed by and construed in accordance with the laws of {{country}}. Any dispute arising out of or in connection with this Notice shall be subject to the exclusive jurisdiction of the courts of {{country}}.

Acknowledgment of Receipt

We kindly request you to acknowledge receipt of this notice and confirm your agreement to the terms stated herein by signing and returning the enclosed duplicate copy of this letter.

Sincerely,

For and on behalf of {{company_name}}

_____________________________

Name: {{authorised_signatory_name}}

Title: {{authorised_signatory_title}}

Acknowledgement by Debentureholder

I/We, {{debentureholder_name}}, hereby acknowledge receipt of this Notice of Cancellation and confirm the cancellation of Debenture Instrument No. {{debenture_number}} as stated herein.

_____________________________

Signature of Debentureholder

Name: {{debentureholder_name}}

Date: {{acknowledgement_date}}